Management of pregnancy and obstetric complications in prehospital trauma care: faculty of prehospital care consensus guidelines

Battaloglu, Emir; Porter, Keith

doi:10.1136/emermed-2016-205978

Cited by 14 publications

(5 citation statements)

References 59 publications

(51 reference statements)

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“… For this category all 27 articles could be retrieved. Of the 13 articles in the trauma systems and care theme, four articles were on the management of different trauma populations, including burn victims requiring escharotomy [ 136 ], pediatric diaphragmatic injuries [ 137 ], pregnant patients [ 138 ], and minor head injuries [ 139 ]. Four articles were on triage [ 140 – 143 ], four were on trauma system assessment or design [ 144 – 147 ], and one was on prehospital levels of care [ 148 ].…”

Section: Resultsmentioning

confidence: 99%

Looking back to inform the future: a review of published paramedicine research

Cavanagh

Blanchard

Weiss

et al. 2023

BMC Health Serv Res

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Objective Paramedicine has evolved in ways that may outpace the science informing these changes. Examining the scholarly pursuits of paramedicine may provide insights into the historical academic focus, which may inform future endeavors and evolution of paramedicine. The objective of this study was to explore the existing discourse in paramedicine research to reflect on the academic pursuits of this community. Methods We searched Medline, Embase, CINAHL, Google Scholar and Web of Science from January, 2006 to April, 2019. We further refined the yield using a ranking formula that prioritized journals most relevant to paramedicine, then sampled randomly in two-year clusters for full text review. We extracted literature type, study topic and context, then used elements of qualitative content, thematic, and discourse analysis to further describe the sample. Results The initial search yielded 99,124 citations, leaving 54,638 after removing duplicates and 7084 relevant articles from nine journals after ranking. Subsequently, 2058 articles were included for topic categorization, and 241 papers were included for full text analysis after random sampling. Overall, this literature reveals: 1) a relatively narrow topic focus, given the majority of research has concentrated on general operational activities and specific clinical conditions and interventions (e.g., resuscitation, airway management, etc.); 2) a limited methodological (and possibly philosophical) focus, given that most were observational studies (e.g., cohort, case control, and case series) or editorial/commentary; 3) a variety of observed trajectories of academic attention, indicating where the evolution of paramedicine is evident, areas where scope of practice is uncertain, and areas that aim to improve skills historically considered core to paramedic clinical practice. Conclusions Included articles suggest a relatively narrow topic focus, a limited methodological focus, and observed trajectories of academic attention indicating where research pursuits and priorities are shifting. We have highlighted that the academic focus may require an alignment with aspirational and direction setting documents aimed at developing paramedicine. This review may be a snapshot of scholarly activity that reflects a young medically directed profession and systems focusing on a few high acuity conditions, with aspirations of professional autonomy contributing to the health and social well-being of communities.

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Section: Resultsmentioning

confidence: 99%

Looking back to inform the future: a review of published paramedicine research

Cavanagh

Blanchard

Weiss

et al. 2023

BMC Health Serv Res

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“…However, these cases are not descriptions of an ideal performance of EH. At least a few meritious papers [2, 8, 17] have reviewed earlier literature and published recommendations for how to perform an EH.…”

Section: Discussionmentioning

confidence: 99%

“…For example, the first EH was performed with a vertical incision, when a horizontal incision was used for the second EH. Both incision strategies lead to a similar result, but the literature suggests a vertical midline laparotomy incision might be better for emergency situations [2, 8, 17] in order to maximize exposure and make the procedure as easy as possible. A beforehand preparation could make procedure more structured and diminish variation between different operators.…”

Section: Discussionmentioning

confidence: 99%

Two cases of low birth weight infant survival by prehospital emergency hysterotomy

Tommila

Pystynen

Soukka

et al. 2017

Scand J Trauma Resusc Emerg Med

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BackgroundDuring maternal cardiac arrest, emergency hysterotomy (EH) is recommended after four minutes of resuscitation, if no signs of spontaneous circulation are detected. This extreme procedure is believed to be potentially beneficial for both the mother and the infant. Both maternal and neonatal survivals seem to be associated to the time delay between the cardiac arrest and the delivery and in-hospital resuscitation location. In addition to this, gestational age is an important determinant to neonatal outcome.Case presentationWe report two emergency hysterotomies executed in an out-of-hospital location. The infants delivered by EH were low birth weight infants and born 20–23 min after maternal cardiac arrest. Both infants survived and had normal physical and neurological growth at the age of two years. Unfortunately, mothers in these both cases died in the field.ConclusionContrary to earlier beliefs, it is possible to perform a successful EH also in out-of-hospital setting, even with incomplete surgical skills. However, training and preparation are extremely important for achieving the highest possible readiness to treat maternal cardiac arrest situations also prehospitally.

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“…Specific guidelines have been developed in recent years and are largely based on expert consensus. 6,7 In this article, we will discuss current views on best practice in the initial resuscitation and subsequent care of the pregnant trauma patient. Considerations relating to non-obstetric surgery during pregnancy will not be discussed in detail and have been covered previously in BJA Education.…”

Section: Key Pointsmentioning

confidence: 99%